DIAPHRAGMATIC FAILURE DURING LOADED BREATHING - ROLE OF NEUROMUSCULAR-TRANSMISSION
DIAPHRAGMATIC FAILURE DURING LOADED BREATHING - ROLE OF NEUROMUSCULAR-TRANSMISSION
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DOI：
10.1152/jappl.1993.74.4.1679
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发表时间：
1993-04-01
影响因子：
3.3
通讯作者：
DONNELLY, DF
中科院分区：
文献类型：
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作者：
BAZZY, AR;DONNELLY, DF
为了确定在负荷呼吸期间中枢或外周机制是否是导致呼吸衰竭的原因，在吸气流量阻力（IFR）负荷呼吸期间，在未麻醉的慢性仪器化绵羊中测量膈神经活动（iENG）、膈肌肌电图（iEMG）和跨膜压（Pdi）。放置IFR负荷后，Pdi最初增加，并在10-30 min内保持相对稳定[Pdi = 69.9 +/- 6.3（SE）cmH 2 O，n = 6];动脉PCO 2也从基线（35.8 +/- 0.9 Torr）增加至55.1 +/- 4.7 Torr。IFR负荷时，iEMG和iENG也较基线增加，但在Pdi平台期，iENG持续增加，iEMG稳定，刺激膈神经诱发的M波在此期间减少。平台期后，Pdi下降，动脉PCO 2增加，此时研究终止（82.1 +/- 20.6分钟）。iENG增加而Pdi和iEMG稳定的观察结果表明神经肌肉传递的效率降低，并表明神经肌肉接头是IFR负荷呼吸期间未麻醉绵羊呼吸衰竭的重要部位。
To determine whether central or peripheral mechanisms are responsible for diaphragmatic failure during loaded breathing, phrenic nerve activity (iENG), diaphragm muscle electromyogram (iEMG), and transdiaphragmatic pressure (Pdi) were measured in unanesthetized chronically instrumented sheep during inspiratory flow-resistive (IFR) loaded breathing. After placement of the IFR load, Pdi increased initially and remained relatively stable for 10-30 min [Pdi = 69.9 +/- 6.3 (SE) cmH2O, n = 6]; arterial PCO2 also increased from baseline (35.8 +/- 0.9 Torr) to 55.1 +/- 4.7 Torr. During IFR loading, iEMG and iENG also increased from baseline, but during the plateau phase of Pdi, iENG continued to increase at the same time while iEMG was stable, and the M wave, evoked bv phrenic nerve stimulation, decreased during this period. After the plateau phase, Pdi decreased and arterial PCO2 increased, at which point the study was terminated (at 82.1 +/- 20.6 min). The observation that iENG increased while Pdi and iEMG were stable demonstrates a reduced efficiency of neuromuscular transmission and suggests that the neuromuscular junction is an important site of diaphragmatic failure in unanesthetized sheep during IFR loaded breathing.